Amendments to the Enhanced Hospitalization Programme (eHOPE)
4.1. Assistant Vice President for Administration Ariel S. Betan presented the proposed amendments to the Enhanced Hospitalization Programme (eHOPE), particularly on three (3) provisions, namely: (1) the increase in the amount of eHOPE benefits from P80,000/year to P100,000/year; (2) the increase in covered hospitalization expenses for professional fees of PhilHealth-accredited physicians and specialists, which is based on the Relative Value Unit (RVU) set by PhilHealth for specific medical cases up to a maximum of twice the amount of RVU; and (3) the inclusion in eHOPE coverage of UP contractuals who have rendered at least one year of continuous service to the University, have an employer-employee relations with the University, and whose salaries are charged against the Revolving Fund//Trust.
4.2. Regent Go inquired about the utilization rate of the eHOPE and the basis for the proposed amount of increase, including the percentage of claimants whose total hospitalization expenses exceeded the eHOPE coverage of P80,000. He said that this data will help the Board see the overall picture of the eHOPE benefit. Assistant Vice President Betan replied that the actual utilization from 2017-2021 is about 3,370 claimants or an average of 674 claimants over a 5-year period, which translates to an average cost to the University of P18 Million-P22 Million per year. In addition, Vice President Balmores reported that based on the data of UP Diliman, around 4% of its total eHOPE claimants had claims in excess of P80,000, which when projected to the entire UP system, would result to an average of 27 claimants whose claims exceed the P80,000 threshold per year. She added that the UP System can afford the additional cost of Php16,000,000.00, which was based on the average number of claimants from 2018 to 2021.
5.1. Regent Pagdanganan explained that considering medical inflation of 30% to 40%, the proposed P20,0000 increase in eHOPE is warranted.
5.2. Regent Belegal informed the Board that the proposed amendments stemmed from the proposal of the two (2) Unions (AUPWU and AUPAEU) for equalization of eHOPE benefits with the UP Manila and UP-PGH employees who have been enjoying a P100,000/year eHOPE coverage since 2017. She said that there were two technical working groups that studied and recommended the proposal. She added that the approval of the additional benefit will give assurance to the UP employees that they have financial support when they need medical attention, especially for the CUs that do not have access to infirmaries or tertiary hospitals.
5.3. On the query of Regent Go regarding the inclusion of UP contractuals to the eligible employees, Assistant Vice President Betan responded that there are about 220 UP contractuals who were excluded from the eHOPE coverage because their salaries are sourced from the Revolving Fund or Trust Fund (RF/TF) of their respective units. Under the current rules, only UP contractuals whose salaries are charged against the General Appropriations Act (GAA) are covered by eHOPE. The proposed amendment before the Board is to include in the eHOPE coverage the UP contractuals whose salaries are charged against the Revolving Fund//Trust Fund.
5.4. Vice President Balmores clarified that the funding for eHOPE is sourced from the income of the University, and not from the GAA or reimbursements from UniFAST. She also assured that the eHOPE benefit for the 220 UP contractuals will be subject to availability of funds of the offices to which they belong. UP Manila Chancellor Carmencita Padilla explained that most of the UP contractuals requesting to be included in the eHOPE coverage are from the National Institutes of Health (NIH) and Institute of Human Genetics (IHG) in UP Manila. She emphasized that the income of the NIH and IHG are all internally generated and do not come from the government.
5.5. After further clarifications and discussions, Regent Pagdanganan moved for the inclusion of the UP contractuals whose salaries are charged against the Revolving Fund/Trust Fund, in the list of eligible staff covered by the eHOPE. For point of order, Regent Ramota moved that the Board approve all amendments as proposed. Regent Belegal seconded the motion, and there being no objections, the same was approved.
5.6. On a related matter, Regent Pagdanganan suggested that the University strengthen its primary care, particularly the UP Health Service, to support the health care of its employees which is consistent with the objectives of the Universal Health Care (UHC). He shared that the PhilHealth is trying to reach out to the infirmaries or health services of the University across the UP system to avail of the UHC benefits. Under the Universal Health Care Law (RA 11223), all Filipinos shall be registered to a Konsulta provider for primary and preventive health care services through the PhilHealth. President Jimenez instructed Vice President Cubillan to coordinate with PhilHealth regarding the matter.
Board Action: APPROVED
